Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I welcome the deputations and thank them all for coming in.

The bed capacity review identified a clear need for additional beds in the system. Mr. Bolger said in his submission that the Minister asked the Department to work with the HSE to identify the location and mix of beds that could be front-loaded in 2018 and into 2019 and 2020. What I have to say might save the Department a great deal of work. The Irish Nurses and Midwives Organisation has identified that 1,000 beds were closed. I do not intend to get into the politics of who closed them and why, but they are closed and clearly available to be reopened. These beds are situated throughout the country. We know of 19 in Letterkenny. I know my colleagues, Deputy Pearse Doherty and Senator Mac Lochlainn, have been campaigning on that. Anyway, the beds are right across the system. Perhaps the deputations can give me their views on where these beds are and how easily they can be accessed. Does the Department intend to front-load them in 2018? The submission is somewhat light on the detail and on where the beds will go. Obviously, those responsible have clear sight of the plans for the 2018 beds and most certainly the 2019 beds, whatever about the other plans. Will the witnesses provide the number and location of the beds?

That leads to my next question. Will the witnesses identify how many of those beds are closed due to staff shortages? I have a view on the relevant numbers.

That leads on to my next question, which is on the funded workforce plan. My understanding is that the Department agreed a funded workforce plan with the nursing unions last year. The Department did not hit those targets, which comes as no surprise, and, in fact, missed them by a considerable amount. Much and all as the Department did not achieve its targets in 2017, there is no funded workforce plan for this year. I understand this matter has been referred to the Workplace Relations Commission. What I do not understand is why there has been a delay in fulfilling what I understand to be an agreement between the Minister and the trade unions representing nurses. Department officials do not need me to tell them but I will explain it for the benefit of saying it. The Department cannot open the beds or solve any of the crises, however these multiple crises were created, unless the hospitals have the staff to do so.

We know the Bring Them Home campaign was a spectacular failure. We know the HSE did not achieve the rather modest targets set out in the funded workforce plan. If we can identify the beds – that would be brilliant – then perhaps the deputations could identify, in the absence of a funded workforce plan, how we will be able to staff those beds.

Will Mr. Woods comment on the practice of counting fourth year nurses as whole-time equivalent, WTE, staff members? In my time, they were not counted as WTE staff. If the HSE has started doing that now, will Mr. Woods explain why? It is not that I am a cynic, of course; I am simply an optimist with experience. Anyway, to the cynical eye, it looks a little like an attempt to massage the staffing figures. I sincerely hope it is not, but Mr. Woods might explain whether that practice has commenced and, if so, why.

Children are waiting for scoliosis surgery. Targets were established and missed. We know the four month waiting target has been missed by a factor of years for some people and for 88 people in total. I spoke to a parent on Monday. She came in to see me in my office. Parents are referring to the practice of what they call aggressive management of lists - these are their words and not necessarily mine. A letter is sent out to the parents of children who have scoliosis severe enough to require surgery asking whether they still want the surgery. I can tell the committee in advance that they still want surgery for their children but they do not get enough time to respond. They refer to this as aggressive management of the waiting list and they are deeply unhappy about it. They see it as a means of perhaps knocking people off the list. Again, that is a mechanism by which the figures could be massaged. Will the deputations comment on that? That seems to be particular to this cohort but that could simply be because these were the people I was talking to recently. We could debate all day whether the practice of sending out letters asking people whether they still want a procedure is a valuable use of time. Certainly, in the case of children with scoliosis it is a reasonable expectation that they will want surgery. The parents are reporting that they get such a short timeframe to respond and this is causing them serious problems.

Mr. Bolger went through all the figures on the National Treatment Purchase Fund. My views on the NTPF are already on record and there is no need for me to rehearse them. The NTPF accounts for 20,000 procedures. I have several questions about the NTPF. Am I right in saying that of the 20,000 procedures a total of 10,000 have been done? Halfway through 2018, how many have been done? What value-for-money metrics does the Department use to assess whether it is getting value for money from the NTPF? How is value for money established? Can the Department point me towards the value-for-money figures, facts and statistics? I simply cannot find them anywhere. Reference is made to how the NTPF will account for 20,000 procedures this year. Can the Department give the committee an indication of how many have been done and how many have been scheduled?